Is intraparum suctioning is safe in newborn born to mother with meconium stain amniotic liquor

Background: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disorder in infants born through meconium-stained amniotic fluid (MSAF). Although anecdotal data concerning the efficacy of intrapartum oropharyngeal and nasopharyngeal suctioning of MSAF are conflicting, the procedure is widely used. We aimed to assess the effectiveness of intrapartum suctioning for the prevention of MAS. Methods: We designed a  prospective quasi randomized control trial, assessor blind, single centre study. 312 patients with MSAF of any consistency, gestational age at least 37 weeks, and cephalic presentation were randomly assigned to suctioning of the oropharynx and nasopharynx (including the hypopharynx) before delivery of the shoulders (n=127), or no suctioning before delivery (n=185). Postnatal delivery-room management followed Neonatal Resuscitation Program guidelines. The primary outcome was incidence of MAS. Clinicians diagnosing the syndrome and designating other study outcomes were masked to group assignment. An informed consent waiver was used. Findings:  No significant difference between treatment groups was seen in the incidence of MAS (36 [26.7%] suction vs 36 [19.5%] no suction; p=0.167),mortality in suction (5 [3.91%] vs no suction( 5 [2.74%]; p=0.779, ) or in the duration of ventilation, oxygen treatment, and hospital care.